Sternoclavicular Dislocations

The sternoclavicular joint is the joint between the end of the clavicle and the sternum (white circle).The sternoclavicular joint is the joint between the clavicle (collarbone) and sternum (breast bone). It is an uncommon injury when you consider all shoulder injuries. It typically occurs in contact and collision sports, such as football and rugby. It is a very painful, and potentially dangerous, injury, and a sports medicine physician should see athletes who are suspected of having this injury immediately.

Typically the athlete is injured with a direct blow, either to the chest or shoulder. Depending on the direction of the force, a blow to the shoulder can cause an anterior or posterior sternoclavicular dislocation. An anterior dislocation of this joint means that the collarbone has popped out in front of the sternum. A posterior dislocation means that the collarbone has gone behind the sternum. While both types of dislocations are very serious, a posterior dislocation can be a surgical emergency, as the end of the collarbone becomes extremely close to the airway and large blood vessels of the heart and chest.

The athlete will complain of pain in the shoulder and/or chest immediately. He likely will have difficulty moving the arm due to the pain. Posterior dislocations can often cause the athlete to have difficulty breathing, and the physician may notice that he is short of breath or wheezing. Note how the end of the left clavicle (which is the one on the right in the image) has dislocated behind the sternum.Physical examination usually shows that the end of the collarbone is very prominent on the injured side if it is an anterior dislocation, and the athlete will be very tender at that location. Evaluation with x-rays, and a CT scan if needed, is critical, so I send players with suspected sternoclavicular dislocations to the emergency room right away.

On this three-dimensional CT scan, note how close the dislocated clavicle is to the large blood vessels of the chest. This injury needs urgent reduction.Treatment of these injuries depends on the direction of the dislocation. Anterior dislocations can be put back in place with gentle pressure on the clavicle, pushing it back in line with the sternum. Sometimes it’s difficult to reduce into the proper position, or it pops back out of place, but fortunately an anterior dislocation leaves only a cosmetic deformity. Usually little long-term functional deficit exists after the athlete has recovered.

A posterior dislocation, on the other hand, needs urgent reduction. Whether this reduction is done in the emergency room or the operating room is controversial. The clavicle needs to be reduced back into place with the sternum to prevent the clavicle from causing injury to the blood vessels and airway nearby. Occasionally surgery to open the joint and manually put the clavicle back into place is needed.

I was involved in a bicycle crash on June 6. I have a broken 4th rib in my back.also my doctor says that Ihave a anterior collarbone – sternum dislocation .there’s not much pain in the collar bone. Some clicking though Full range of colours in bruising on right side of chest. doc says to just leave it alone ,and start doing some light range of motion exercises .In your opinion is this the correct course of action ?I was in the whirlpool today and did some easy yoga moves,good results. Not using sling , able to drive car ,shift gears. Am I making things better or worse? Using less Ibuprofen each day.

I have a dislocation in both my right AC & SC joints, they both make the clavicle to appear raised to the outside (piano-key), the displacement is about half centimeter (quarter inch) near the AC end and quarter centimeter (eighth of an inch) from the SC end of the clavicle, is there away to force the clavicle into its place manually without surgery?
(if so please what’s this process called, and what specialist should I be seeing?). Thank you so much.

Typically it is not possible to reduce the clavicle and keep it in place without a surgical procedure. Depending on the extent of injury, though, many patients do not need surgery to regain full function.

Please note: I cannot and will not provide specific medical information within these comments, just as I won't anywhere else. Also, I reserve the right to delete comments that are offensive, off-topic, or spam. If you have questions, please read My Comments Policy.

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About Dr. David Geier

I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

On this blog, on my podcast, and in articles for numerous publications and in media interviews, I aim to provide you leading commentary and education on injury treatment and prevention to keep you performing at your best!

I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

On this blog, on my podcast, and in articles for numerous publications and in media interviews, I aim to provide you leading commentary and education on injury treatment and prevention to keep you performing at your best! Learn more about me >>

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